At a cross road what to do…. RP (Gold Standard) or Da Vinci Robotic?

bdhilton
bdhilton Member Posts: 803 Member
edited March 2014 in Prostate Cancer #1
On December 28, 2009 I was diagnosed with PC. I just turned 55. My PSA is between 2.8-4.10 (two test within a week in December 09). I had a 15 core biopsy and have been diagnosed with Stage T2B with Gleason grade 7 cancer (4+3). My bone scan and CT were negative. This was stated during my annual physical on Dec 4th when my doctor noted a “lump” during my DRE and referred me to a Urologist.

My Urologist has a thriving practice here in the Southeast USA (2 da vinci surgeons on staff and one being the director of Robotics at one of the major hospitals here in the south east) but my own Urologist is recommending that I go to Northwestern in Chicago and have a radical prostatectomy performed by one of the first surgeons to perform and perfect nerve sparing surgery in radical prostatectomy operations and has preformed more than 5,000 RP’s.

My Urologist’s main reason is that he believes that this will be my best chance to get the cancer out the first time without radiation because of my bulge in my tumor. If I go with the Da Vinci process (with a very experience surgeon in his group) he is concerned that this process may leave me positive on one side after the da vinci process and I will need radiation…

Outside of PC I am in good health, not overweight and workout 5-6 times a week.

My priorities are eliminating the cancer, continence and sparing my nerves to remain potent (never thought that would be the third item on a list of priorities :-))

Anyway most perplexed right now and if anyone has advice about their experiences between da vinci and RP (gold standard) I am all ears…Da Vinci sounds so much better than the RP Gold Standard process…

Thank you in advance for any advice or help!
«13

Comments

  • marc1957
    marc1957 Member Posts: 79
    Personally I would speak
    Personally I would speak with both surgeons you are considering, get their biased inputs, then make your own decision based upon that.
  • bdhilton
    bdhilton Member Posts: 803 Member
    marc1957 said:

    Personally I would speak
    Personally I would speak with both surgeons you are considering, get their biased inputs, then make your own decision based upon that.

    Biased inputs isn’t that the truth
    Thanks for your response…Biased inputs isn’t that the truth…that makes me smile.

    What makes this difficult for me is that my urologist oncologist who owns the practice with 2 da vinci surgeons on staff is recommending I go spend my money up at Northwestern for an open RP….and the da vinci surgeon (listed as one of the best in the southeast) he has on staff has told me he will get 100% of my cancer… like this is not hard enough…thanks again
  • whipple
    whipple Member Posts: 11
    How to compare results
    My husband had the Divinci at Northwestern by Dr. Nadler. He is also Gleason 4+3 and the pathology after surgery is T3C. He is going to have radiation but we haven't met with the radiation oncologist and dont know if they will also do hormone therapy. They want to wait and let the body heal before stating the radiation. My sister inlaw just sent me this article that I think will help you. It is from Johns Hopkins Medicine Urology, A publication of the Patrick C. Walsh Prostate Cancer Research Fund. Volume V, Winter of 2009 How to compare results. If you cant find it email me at [email protected] and I will forward it to you. Best Wishes Jude
  • whipple
    whipple Member Posts: 11
    bdhilton said:

    Biased inputs isn’t that the truth
    Thanks for your response…Biased inputs isn’t that the truth…that makes me smile.

    What makes this difficult for me is that my urologist oncologist who owns the practice with 2 da vinci surgeons on staff is recommending I go spend my money up at Northwestern for an open RP….and the da vinci surgeon (listed as one of the best in the southeast) he has on staff has told me he will get 100% of my cancer… like this is not hard enough…thanks again

    100%
    I cant believe someone would say they can get 100% of your cancer. I wouldn't trust that.
  • bdhilton
    bdhilton Member Posts: 803 Member
    whipple said:

    How to compare results
    My husband had the Divinci at Northwestern by Dr. Nadler. He is also Gleason 4+3 and the pathology after surgery is T3C. He is going to have radiation but we haven't met with the radiation oncologist and dont know if they will also do hormone therapy. They want to wait and let the body heal before stating the radiation. My sister inlaw just sent me this article that I think will help you. It is from Johns Hopkins Medicine Urology, A publication of the Patrick C. Walsh Prostate Cancer Research Fund. Volume V, Winter of 2009 How to compare results. If you cant find it email me at [email protected] and I will forward it to you. Best Wishes Jude

    thanks
    I found it and read it> I am debating open RP at Northwestern or the Da Vinci method in the South East...Best wishes to you and your husband
  • randy_in_indy
    randy_in_indy Member Posts: 496 Member
    bdhilton said:

    thanks
    I found it and read it> I am debating open RP at Northwestern or the Da Vinci method in the South East...Best wishes to you and your husband

    Debating...
    I have similar stats to you which I will post below here....but prior to surgery mine looked better 3+3=6 only right side with a palpaple tumor felt in DRE. Did a MRI with coil and they said it was organ confined. So I stuck with Da Vinci surgery 12/29/09. I really never considered RP because of the down time afterward...probably not right when we are talking about cancer but I just saw all the benefits from Robotic that I liked...away from work less. quicker recovery to get back to doing things...and the nice success rate of the experienced local team here in Indianapolis. Now my post op path came back with more aggresive cancer as you can see below...and the part that is ugly for me is the extraprostatic extension that occured on both the right and left side anterior=front. I look at this as a huge ? of whether I will be dealing with this down the road again some day with radiation. The really good part of the path report is no positive margins...and the only other concer was the perineural invasion....which I found out today is extremely common on Post Op path reports because there are nerves that go into the center of the prostate and run through it so if there is cancer in there it goes to reason the nerves inside the prostate would like have invasion. I was concerned that it was with the nerves attached to the outside of the prostate which it was told most likely not...since there was none in the surgical margin which is all the tissue they take from around the entire sphere of the prostate. I like the other comment about interviewing the docs and see what they say then making a decision....I can tell from reading on here for several months that no matter what path you choose...and no matter what results you get after the choosen treatment...cancer can come back....I honestly think it's somewhat luck that determines who gets it back and who doesn't. My best advise find the one that turns you on the most with his answers and the one you feel the most confident with as far as his skill level.....what I found leading up to my surgery after I had made the decision was everyone around said ...you got the best guys....even other docs said they would use who I used if they had it and were going to do the robotic. I am now two weeks from the day from my surgery...and honestly...I could go out and play at least 9 holes...maybe even 18 tomorrow. I have never really felt tired or out of energy...I was out runining around shoping for 5 hours yesterday and yes when I got home felt a little tired but man this has been a peice of cake with the worst part for me being the bowel movements and catheter...which I had to keep an extra week and got out today...YEEEEEEEEHAWWWWWWW! I'm friken free...and actually going to the bathroom and peeing on my own. I am on my second pad since the removal at 11 am this morning but its pretty darn dry....so hope I am continent soon....I am also doing a no, no drinking a beer right now...but heck a person has to have some fun....heck its a flat two week old home brew so the carbination is not a factor...well see how the bladder reacts. Good luck with your decision! here are my full stats.

    52 years old
    PSA 9/09 7.25
    PSA 10/09 6.125
    Diagnosis confirmed Oct 27, 2009
    8 Needle Biopsy = 5 clear , 3 postive
    <20%, 10%, 10%
    Gleason Score (3+3) 6 in all positive cores
    11/09 Second Opinion on Biopsy slides from Dr. Koch
    (4+3) = 7 5%
    (3+4) = 7 10%
    (3+4) = 7 10%
    Endorectol MRI with Coil - Indicated the Palpal tumor was Organ confined
    da Vinci 12/29/09 - Dr. Hollensbee & Scott
    Post Surgery Pathology:
    Prostate size 5 x 4 x 3.5 cm Weight: 27 g
    Gleason: Changed to (3+4) = 7
    Primary Pattern 3, 80%
    Secondary Pattern 4, 18%
    Tertiary Pattern 5, 2%
    Tumor Quantitation:
    Greatest Dimension, Largest tumor focus: 19 mm
    Additional Dimension 18 x 15 mm
    Location, largest tumor focus: Right posterior quadrant
    Multifocality: Yes
    Greatest dimension second largest focus 10 mm
    Location: second largest focus: Left Posterior quadrant
    Extraprostatic extension: Yes
    If yes, focal or non-focal: Nonfocal
    If yes: location(s) right and left antero-lateral
    Seminal vesicle invasion: No
    Cancer at surgical margin: No
    If no, closest distance with location: less than 1 mm, right posterior quadrant
    Apex involvement: No
    Bladder involvement: NO
    Lymph-vascular invasion: No
    Perineural invasion: Yes
    Lymph nodes: 9 from right pelvic 0/9 positive
    Stage: pT3a, pNO, pMX
    All nerves sparred - found two additional pudendal arteries
  • bdhilton
    bdhilton Member Posts: 803 Member

    Debating...
    I have similar stats to you which I will post below here....but prior to surgery mine looked better 3+3=6 only right side with a palpaple tumor felt in DRE. Did a MRI with coil and they said it was organ confined. So I stuck with Da Vinci surgery 12/29/09. I really never considered RP because of the down time afterward...probably not right when we are talking about cancer but I just saw all the benefits from Robotic that I liked...away from work less. quicker recovery to get back to doing things...and the nice success rate of the experienced local team here in Indianapolis. Now my post op path came back with more aggresive cancer as you can see below...and the part that is ugly for me is the extraprostatic extension that occured on both the right and left side anterior=front. I look at this as a huge ? of whether I will be dealing with this down the road again some day with radiation. The really good part of the path report is no positive margins...and the only other concer was the perineural invasion....which I found out today is extremely common on Post Op path reports because there are nerves that go into the center of the prostate and run through it so if there is cancer in there it goes to reason the nerves inside the prostate would like have invasion. I was concerned that it was with the nerves attached to the outside of the prostate which it was told most likely not...since there was none in the surgical margin which is all the tissue they take from around the entire sphere of the prostate. I like the other comment about interviewing the docs and see what they say then making a decision....I can tell from reading on here for several months that no matter what path you choose...and no matter what results you get after the choosen treatment...cancer can come back....I honestly think it's somewhat luck that determines who gets it back and who doesn't. My best advise find the one that turns you on the most with his answers and the one you feel the most confident with as far as his skill level.....what I found leading up to my surgery after I had made the decision was everyone around said ...you got the best guys....even other docs said they would use who I used if they had it and were going to do the robotic. I am now two weeks from the day from my surgery...and honestly...I could go out and play at least 9 holes...maybe even 18 tomorrow. I have never really felt tired or out of energy...I was out runining around shoping for 5 hours yesterday and yes when I got home felt a little tired but man this has been a peice of cake with the worst part for me being the bowel movements and catheter...which I had to keep an extra week and got out today...YEEEEEEEEHAWWWWWWW! I'm friken free...and actually going to the bathroom and peeing on my own. I am on my second pad since the removal at 11 am this morning but its pretty darn dry....so hope I am continent soon....I am also doing a no, no drinking a beer right now...but heck a person has to have some fun....heck its a flat two week old home brew so the carbination is not a factor...well see how the bladder reacts. Good luck with your decision! here are my full stats.

    52 years old
    PSA 9/09 7.25
    PSA 10/09 6.125
    Diagnosis confirmed Oct 27, 2009
    8 Needle Biopsy = 5 clear , 3 postive
    <20%, 10%, 10%
    Gleason Score (3+3) 6 in all positive cores
    11/09 Second Opinion on Biopsy slides from Dr. Koch
    (4+3) = 7 5%
    (3+4) = 7 10%
    (3+4) = 7 10%
    Endorectol MRI with Coil - Indicated the Palpal tumor was Organ confined
    da Vinci 12/29/09 - Dr. Hollensbee & Scott
    Post Surgery Pathology:
    Prostate size 5 x 4 x 3.5 cm Weight: 27 g
    Gleason: Changed to (3+4) = 7
    Primary Pattern 3, 80%
    Secondary Pattern 4, 18%
    Tertiary Pattern 5, 2%
    Tumor Quantitation:
    Greatest Dimension, Largest tumor focus: 19 mm
    Additional Dimension 18 x 15 mm
    Location, largest tumor focus: Right posterior quadrant
    Multifocality: Yes
    Greatest dimension second largest focus 10 mm
    Location: second largest focus: Left Posterior quadrant
    Extraprostatic extension: Yes
    If yes, focal or non-focal: Nonfocal
    If yes: location(s) right and left antero-lateral
    Seminal vesicle invasion: No
    Cancer at surgical margin: No
    If no, closest distance with location: less than 1 mm, right posterior quadrant
    Apex involvement: No
    Bladder involvement: NO
    Lymph-vascular invasion: No
    Perineural invasion: Yes
    Lymph nodes: 9 from right pelvic 0/9 positive
    Stage: pT3a, pNO, pMX
    All nerves sparred - found two additional pudendal arteries</p>

    I think I'll have a scotch
    Sounds like you are doing great and that makes me happy as we are all now members of this “reluctant” club… I love stats and I sincerely appreciate you providing the details you did. I believe what you do in that “no matter what results you get after the chosen treatment...cancer can come back.... it's somewhat luck that determines who gets it back and who doesn't….” Your advise in that “find the one that turns you on the most with his answers and the one you feel the most confident with as far as his skill level..” is what I continue to struggle with.

    My urologist is a well regarded oncologist I the States and is giving me treatment advise he gave to his own brother (who I know) go to Northwestern and get an “open RP” outside of his clinic… but my first “gut” was da vinici with this particular surgeon in Atlanta before I saw my urologist and that is why I keep struggling…As you know you can only get it right once …My wife says I am crazy and should listen to my urologist advise and I am still listening to my gut and go with da vinci and this other surgeon…I am also talking with Vattikuti Urology Institute tomorrow but bottom line for me is that “what will be will be” and I am a surgical candidate plus I have an obligation to climb Half Dome this Summer (do not know I will be recovered with an open RP by then) and dispose of my fathers ashes as one of his last request (taught me how to climb and love the outdoors many decades ago …) still a quandary for me ,,,thanks again for the thoughts and information
  • fathersson
    fathersson Member Posts: 121
    bdhilton said:

    I think I'll have a scotch
    Sounds like you are doing great and that makes me happy as we are all now members of this “reluctant” club… I love stats and I sincerely appreciate you providing the details you did. I believe what you do in that “no matter what results you get after the chosen treatment...cancer can come back.... it's somewhat luck that determines who gets it back and who doesn't….” Your advise in that “find the one that turns you on the most with his answers and the one you feel the most confident with as far as his skill level..” is what I continue to struggle with.

    My urologist is a well regarded oncologist I the States and is giving me treatment advise he gave to his own brother (who I know) go to Northwestern and get an “open RP” outside of his clinic… but my first “gut” was da vinici with this particular surgeon in Atlanta before I saw my urologist and that is why I keep struggling…As you know you can only get it right once …My wife says I am crazy and should listen to my urologist advise and I am still listening to my gut and go with da vinci and this other surgeon…I am also talking with Vattikuti Urology Institute tomorrow but bottom line for me is that “what will be will be” and I am a surgical candidate plus I have an obligation to climb Half Dome this Summer (do not know I will be recovered with an open RP by then) and dispose of my fathers ashes as one of his last request (taught me how to climb and love the outdoors many decades ago …) still a quandary for me ,,,thanks again for the thoughts and information

    Similar place
    Incredible how confusing all of this can be. I was diagnosed as a gleason 6 with one core out of 12 containing less than 5% of cancer. Also 2 other cores were indicating some precancerous abnormalities.. Urologist recs robotic removal. Go for a 2nd opinion and consult with another highly reputable surgeon/urologist next week. In the meantime, I am getting hammered from anyone who cares with all sorts of reccomendation as to who to see, whether to watch and wait, what type of surgery I should get..when I should get it..and... you name it. All great input from people who truly care. That said, it kinda sucks because it confuses you as to "what to do". and I have read and researched everything and truly understand the ramifications of any decision I make...I think the advise as to whatever turns you on is right on target because in the end.. we need to feel comfortable with whom and what we choose to do.. So .. good luck and hopefully we both make the right decisions...

    Best.
  • txbarton
    txbarton Member Posts: 89 Member
    bdhilton said:

    I think I'll have a scotch
    Sounds like you are doing great and that makes me happy as we are all now members of this “reluctant” club… I love stats and I sincerely appreciate you providing the details you did. I believe what you do in that “no matter what results you get after the chosen treatment...cancer can come back.... it's somewhat luck that determines who gets it back and who doesn't….” Your advise in that “find the one that turns you on the most with his answers and the one you feel the most confident with as far as his skill level..” is what I continue to struggle with.

    My urologist is a well regarded oncologist I the States and is giving me treatment advise he gave to his own brother (who I know) go to Northwestern and get an “open RP” outside of his clinic… but my first “gut” was da vinici with this particular surgeon in Atlanta before I saw my urologist and that is why I keep struggling…As you know you can only get it right once …My wife says I am crazy and should listen to my urologist advise and I am still listening to my gut and go with da vinci and this other surgeon…I am also talking with Vattikuti Urology Institute tomorrow but bottom line for me is that “what will be will be” and I am a surgical candidate plus I have an obligation to climb Half Dome this Summer (do not know I will be recovered with an open RP by then) and dispose of my fathers ashes as one of his last request (taught me how to climb and love the outdoors many decades ago …) still a quandary for me ,,,thanks again for the thoughts and information

    Just because your urologist has daVinci surgeons on staff
    Just because your urologist has daVinci surgeons on staff does not mean he is supportive of daVinci. My urologist advised against daVinci for me but I sought another opinion and went with daVinci on 7 Oct.

    My pre-op was Gleason 3+3 with PNI. My post-op was Gleason 4+3 with cancer outside the capsule. My 8 weeks PSA was "<0.04 (undetectable)".

    My 36 year old son is a pancreatic surgeon. He and my urologist who is ~65 years old both admit that daVinci is new enough that older urologists/surgeons are reluctant to accept/recommend it.

    Seek another opinion befor you commit.

    Good luck.

    VB
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    hi
    we can provide better advice if you mention the surgeons that you are considering and their experience.......specifically, please tell us more about the robotic surgeons that you are considering........you can mention the names of the surgeons....for us, its like collecting baseball cards when we were children........there are stars and superstars, and pretend stars.

    ira
  • bdhilton
    bdhilton Member Posts: 803 Member

    Similar place
    Incredible how confusing all of this can be. I was diagnosed as a gleason 6 with one core out of 12 containing less than 5% of cancer. Also 2 other cores were indicating some precancerous abnormalities.. Urologist recs robotic removal. Go for a 2nd opinion and consult with another highly reputable surgeon/urologist next week. In the meantime, I am getting hammered from anyone who cares with all sorts of reccomendation as to who to see, whether to watch and wait, what type of surgery I should get..when I should get it..and... you name it. All great input from people who truly care. That said, it kinda sucks because it confuses you as to "what to do". and I have read and researched everything and truly understand the ramifications of any decision I make...I think the advise as to whatever turns you on is right on target because in the end.. we need to feel comfortable with whom and what we choose to do.. So .. good luck and hopefully we both make the right decisions...

    Best.

    Similar Place...
    Thanks for your response and the best to you in your personal selection process. I have had to make snap decisions most of my professional life and I remain in a quandary on this one….but I know for me in the end I have to “believe” that my selection is the best no matter what the outcome is….

    It is interesting how “one” think about cancer based on “their” degree/state of cancer. I’m a Pre-Op stage T2B with a Gleason 4+3 =7 … I am struggling with Open vs robotic because of my stage and the advantages vs disadvantages between Open vs Robotic and the primary reason is the surgeons ability to “feel” your tissue in the Open process…anyway if I had a Gleason 6 (which I do not) I would be pointing towards da vinci with an experience surgeon but again at the end of the day it is what you believe is best for you …best of luck in this process
  • bdhilton
    bdhilton Member Posts: 803 Member

    hi
    we can provide better advice if you mention the surgeons that you are considering and their experience.......specifically, please tell us more about the robotic surgeons that you are considering........you can mention the names of the surgeons....for us, its like collecting baseball cards when we were children........there are stars and superstars, and pretend stars.

    ira

    stars, superstars, or pretend stars?
    Da Vinci:
    Nikhil Shah-St Joe/Atlanta
    Mani Menon-Henry Ford/Detroit

    Open RP-
    William J Catalona-Northwestern/Chicago
    Emory University-Still interviewing
  • bdhilton
    bdhilton Member Posts: 803 Member
    txbarton said:

    Just because your urologist has daVinci surgeons on staff
    Just because your urologist has daVinci surgeons on staff does not mean he is supportive of daVinci. My urologist advised against daVinci for me but I sought another opinion and went with daVinci on 7 Oct.

    My pre-op was Gleason 3+3 with PNI. My post-op was Gleason 4+3 with cancer outside the capsule. My 8 weeks PSA was "<0.04 (undetectable)".

    My 36 year old son is a pancreatic surgeon. He and my urologist who is ~65 years old both admit that daVinci is new enough that older urologists/surgeons are reluctant to accept/recommend it.

    Seek another opinion befor you commit.

    Good luck.

    VB</p>

    Just becuase...
    You sound like you are doing great and made the right decision for you. Your advice is solid-thanks I'm a 4+3 pre op but what was your turning point for open vs robotic?
  • WHW
    WHW Member Posts: 189
    Good Article of Open vs da Vinci
    BD,

    Try this article for a comprehensive review of the two techniques.

    http://www.expert-reviews.com/doi/pdf/10.1586/14737140.8.6.843

    I also have a bookmark on the outcomes of the two procedures. I am trying to locate it and will post it as soon as I can.

    Sonny
  • WHW
    WHW Member Posts: 189
    Another Comparison
    Here is another worth reading article.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2014804/

    By the way, as many here know, I had my da Vinci surgery done by Mani Menon at Henry Ford in Detroit.

    I went through much the same discovery process as you. I live in Orlando, Fl and my local Urology office is well respected. They also have open and robotic surgeons in house. I decided on surgery as my first form of treatment, which would leave me other options if I needed them.

    Once that decision was made I researched heavily the differences in open vs robotic. I decided on robotic and then went on a search for what I felt was the best. There are many notable and really good da Vinci surgeons in the country but my quest lead me to Dr. Mani Menon.

    I could not have been more pleased with my experience. My surgery, recovery and return to continence were all non events and are well documented here.

    Unfortunately my cancer decided not to cooperate. At present I am two treatments away from completing 35 IMRT radiation treatments. However, there is no doubt in my mind that nothing could have been done further in my surgery to guarantee success. That is truly the world of PCa and it operates differently in each and every individual.

    I was totally continent from the time the catheter was removed and at only 3 1/2 months post surgery am seeing strong signs in recovery of normal sexual function. I attribute both of these successes to Dr. Menon and the surgical techniques that he has developed to address these two issues. Many of the top surgeons in the country as using the techniques and refinements that were developed by Dr. Menon.

    Good luck in your quest for knowledge and the comforts of your decision,

    Sonny
    61 years old
    PSA 11/07 3.0
    PSA 5/09 6.4
    Diagnosis confirmed July 9, 2009
    12 Needle Biopsy = 9 clear , 3 postive
    <5%, 90%, 40%
    Gleason Score (3+4) 7 in all positive cores
    CT Organ Scan - negative
    Nuclear Bone Scan - Negative
    da Vinci 9/17/09
    Post Surgery Pathology:
    Gleason: Changed to (4+3) = 7
    Stage: T3a
    Tumor Volume 12.5%
    NERVES SPARED-positive margin, extra-prostatic extension
    30 day PSA 0.4, 50 day psa 0.53, 64 day psa 0.6
    IMRT began Nov 30,2009 (74 days post surgery)35 treatments total 70Gy
  • bdhilton
    bdhilton Member Posts: 803 Member
    WHW said:

    Another Comparison
    Here is another worth reading article.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2014804/

    By the way, as many here know, I had my da Vinci surgery done by Mani Menon at Henry Ford in Detroit.

    I went through much the same discovery process as you. I live in Orlando, Fl and my local Urology office is well respected. They also have open and robotic surgeons in house. I decided on surgery as my first form of treatment, which would leave me other options if I needed them.

    Once that decision was made I researched heavily the differences in open vs robotic. I decided on robotic and then went on a search for what I felt was the best. There are many notable and really good da Vinci surgeons in the country but my quest lead me to Dr. Mani Menon.

    I could not have been more pleased with my experience. My surgery, recovery and return to continence were all non events and are well documented here.

    Unfortunately my cancer decided not to cooperate. At present I am two treatments away from completing 35 IMRT radiation treatments. However, there is no doubt in my mind that nothing could have been done further in my surgery to guarantee success. That is truly the world of PCa and it operates differently in each and every individual.

    I was totally continent from the time the catheter was removed and at only 3 1/2 months post surgery am seeing strong signs in recovery of normal sexual function. I attribute both of these successes to Dr. Menon and the surgical techniques that he has developed to address these two issues. Many of the top surgeons in the country as using the techniques and refinements that were developed by Dr. Menon.

    Good luck in your quest for knowledge and the comforts of your decision,

    Sonny
    61 years old
    PSA 11/07 3.0
    PSA 5/09 6.4
    Diagnosis confirmed July 9, 2009
    12 Needle Biopsy = 9 clear , 3 postive
    <5%, 90%, 40%
    Gleason Score (3+4) 7 in all positive cores
    CT Organ Scan - negative
    Nuclear Bone Scan - Negative
    da Vinci 9/17/09
    Post Surgery Pathology:
    Gleason: Changed to (4+3) = 7
    Stage: T3a
    Tumor Volume 12.5%
    NERVES SPARED-positive margin, extra-prostatic extension
    30 day PSA 0.4, 50 day psa 0.53, 64 day psa 0.6
    IMRT began Nov 30,2009 (74 days post surgery)35 treatments total 70Gy</p>

    Another Comparison...
    Sonny...thanks for the article and your details above. I have also read many of your comment within this discussion group.

    I love your belief that your choice was the best choice...and that is the only thought you can have after your treatment. I feel I need to make my decision in the next 2 days or so(6 week anniversary of my biopsy on Friday) but I am sure I will ponder this over the weekend...Thanks again BD
  • jminnj
    jminnj Member Posts: 129
    bdhilton said:

    Another Comparison...
    Sonny...thanks for the article and your details above. I have also read many of your comment within this discussion group.

    I love your belief that your choice was the best choice...and that is the only thought you can have after your treatment. I feel I need to make my decision in the next 2 days or so(6 week anniversary of my biopsy on Friday) but I am sure I will ponder this over the weekend...Thanks again BD

    bd
    I am 47 and was diagnosed

    bd

    I am 47 and was diagnosed in November, PSA was 2.9 and had 1 core positive (10%), 2 others that showed abnormalities. My urologist walked me through the various options, made his recommendation (da vinci)and then told me to go get a second opinion. I went to Sloan Kettering in NJ and met with their urologist/oncologist. He again walked me through all the options (pros and cons). Ulimately I decided to have the da vinci (scheduled for next Thursday). I did a lot of research and feel that this is the right option for me. I personnally do not think that there is one right answer that applies to everyone. Each one of us has our own unique set of circumstances and in the end we need to feel comfortable with our decision. I wish you peace of mind during this time and all the best with whatever treatment option you decide upon.

    Good Luck
    Joe
  • bdhilton
    bdhilton Member Posts: 803 Member
    jminnj said:

    bd
    I am 47 and was diagnosed

    bd

    I am 47 and was diagnosed in November, PSA was 2.9 and had 1 core positive (10%), 2 others that showed abnormalities. My urologist walked me through the various options, made his recommendation (da vinci)and then told me to go get a second opinion. I went to Sloan Kettering in NJ and met with their urologist/oncologist. He again walked me through all the options (pros and cons). Ulimately I decided to have the da vinci (scheduled for next Thursday). I did a lot of research and feel that this is the right option for me. I personnally do not think that there is one right answer that applies to everyone. Each one of us has our own unique set of circumstances and in the end we need to feel comfortable with our decision. I wish you peace of mind during this time and all the best with whatever treatment option you decide upon.

    Good Luck
    Joe

    Best to you on your pending surgery
    Joe,

    Thanks and what I am seeing are a few common themes or threads with folks that have gone through this and are confident with their decision::

    1. There is one right answer that applies to everyone.
    2. Each one of us has our own unique set of circumstances
    3. In the end we need to feel comfortable with our decision.

    Thanks again,

    BD
  • RichardRS
    RichardRS Member Posts: 44
    Robotic vs Open
    I was a surgical technician (like a operating room scrub nurse). What convinced me to go robotic was the visualization and magnification possible in the robotic procedure. Look at some of the clips online (You Tube and Doctor's sites) showing the procedure. I was totally pleased with the quality, outcome, and lack of pain in this procedure.
  • NM
    NM Member Posts: 214
    RichardRS said:

    Robotic vs Open
    I was a surgical technician (like a operating room scrub nurse). What convinced me to go robotic was the visualization and magnification possible in the robotic procedure. Look at some of the clips online (You Tube and Doctor's sites) showing the procedure. I was totally pleased with the quality, outcome, and lack of pain in this procedure.

    Both surgeries do the main thing ,remove the cancer
    Hi ,Nick here and im going to throw my hat into the ring. First of all did you get a second opinion? John Hopkins is a good option if you didnt,that said I chose Davinci for 2 main reasons.

    I had to keep working,I know this sounds like a dumb reason but mortages must be paid and food bought and I am not yet wealthy,lol

    And the second reason was removing the cancer,obvious of course with as little side effects as possible. I had Davinci on Sept 3rd and am back to work,lifting weights and doing whatever I like.

    On a lesser note I had no dietary restrictions and didnt watch my liquid intake from day 1 and no incontinence,meaning I was the same as before.(beer was included in my diet)

    Hope this helps and prayers to you.

    Nick age 52...